The importance of internal strain as opposed to interface pressure in the prevention of pressure related deep tissue injury.

For pressure ulcer prevention an ambitious goal would be the establishment of a mechanical threshold for tissue damage. In the past, several researchers have sought to establish such a threshold often involving the loading time. However, they have not resulted in a unique reliable value that could be used in practice. This limitation is probably due to the focus on interface pressure. The objective of this paper is to clarify to an audience with no conventional background in mechanics, why interface pressure is not the appropriate parameter to define a damage threshold, whereas internal local deformations (strains) may prove more suitable. The paper reveals that it may be possible to identify a damage threshold for healthy skeletal muscle tissue based on local internal deformations.

[1]  Klaas Nicolay,et al.  Role of ischemia and deformation in the onset of compression-induced deep tissue injury: MRI-based studies in a rat model. , 2007, Journal of applied physiology.

[2]  M. Kosiak,et al.  Etiology and pathology of ischemic ulcers. , 1959, Archives of physical medicine and rehabilitation.

[3]  L. Bennett,et al.  Shear vs pressure as causative factors in skin blood flow occlusion. , 1979, Archives of physical medicine and rehabilitation.

[4]  Y. Itzchak,et al.  Assessment of mechanical conditions in sub-dermal tissues during sitting: a combined experimental-MRI and finite element approach. , 2007, Journal of biomechanics.

[5]  Debby Gawlitta,et al.  Deep tissue injury: how deep is our understanding? , 2008, Archives of physical medicine and rehabilitation.

[6]  Cwj Cees Oomens,et al.  Compression-Induced Tissue Damage: Animal Models , 2005 .

[7]  A. Stekelenburg.  Mechanisms associated with deep tissue injury induced by sustained compressive loading , 2005 .

[8]  J. Carney,et al.  Evaluation of ibuprofen for pressure ulcer prevention: application of a rat pressure ulcer model. , 1995, Advances in wound care : the journal for prevention and healing.

[9]  D. Bader.  The impact of bioengineering on tissue viability research. , 2002, Journal of tissue viability.

[10]  M. Kosiak,et al.  Etiology of decubitus ulcers. , 1961, Archives of physical medicine and rehabilitation.

[11]  D L Bader,et al.  A new MR-compatible loading device to study in vivo muscle damage development in rats due to compressive loading. , 2006, Medical engineering & physics.

[12]  Dinsdale Sm,et al.  Decubitus ulcers in swine: light and electron microscopy study of pathogenesis. , 1973 .

[13]  Dan L. Bader,et al.  Pressure ulcer research : current and future perspectives , 2005 .

[14]  E. Bosboom.  Deformation as a trigger for pressure sore related muscle damage , 2001 .

[15]  F P T Baaijens,et al.  Compression-induced damage and internal tissue strains are related. , 2008, Journal of biomechanics.

[16]  R. Daniel,et al.  Etiologic factors in pressure sores: an experimental model. , 1981, Archives of physical medicine and rehabilitation.